Notes from Dr. Arunkumar on the Nipah Virus

Dr G Arunkumar, Head of the Manipal Center for Virus Research (MCVR), spoke with journalists in Kozhikode on June 2, 2018. After the confirmation of the Nipah virus disease in Perambra, he reached the city on the same day and has since then been leading the Government health system’s surveillance activities. Below are excerpts from the interview:

1. There is no need to worry about Nipah’s second wave. Only a few more cases may come. Those are from the contacts of cases in Balussery and Mukkam areas.

2. The virus is not transmitted in the mild fever phase. The transmission occurs only when the symptoms are severe.

3. The 17 cases of deaths from the NiV are from the index case (From Sabith). The virus had spread from two point of contacts - i.e from Perambra Taluk Hospital and Medical College and Hospital in Kozhikode.

4. In spite of close contacts getting infected, Sabith and Salih’s mother remains uninfected. This could probably be because of the fact that she would have covered her face while taking care of them; she would have unknowingly used something that prevented the infected droplets from reaching her, something like covering the face with the end of a saree.

5. In case of Nipah transmission, the nature of contact is more important than the person's immunity. However, a nursing student who is recovering at MCH has succeeded in overcoming the infection. Her condition was worse previously, but her body has responded miraculously to Ripavirin. The current status of the other person who was positive for Nipah is also promising as he is also recovering.

Deccan ChronicleNipah Virus: No more harm, says Doctor"The second wave will be much weaker. The most important thing is not to miss even a single case."

6. Most of the cases got infected with the virus from the narrow corridor of the radiology section at the medical college in Kozhikode. When Sabith was brought for a scan in this area on May 5, the bystanders in the waiting area in the narrow corridor got infected.

7. Finding the source of Nipah is very challenging. We may be able to find the virus only in 4-5 fruit bats out of one lakh bats, that too only at specific times (during breeding season, times of stress etc.)

​8. Fruits half-eaten by bats can be a definite source of Nipah. But what happened in Perambra is more likely to be in a different way. Sabith was an animal lover. He has pet rabbits at home. He may have had a contact with a bat or a newborn bat (December to May is the breeding season). If it was from fruits half-eaten by bats, we would have seen more cases from the area.

9. Public need not wear masks everywhere. But those who are in close contact with patients are required to wear masks and gloves when handling patients.

10. The authorities have responded effectively to this crisis. Kerala can be proud of this. All the 17 people who died from Nipah, got infected before we could identify and confirm the infection as Nipah.

11. It is very rare for Nipah to be transmitted from bats. But once it infects humans, the transmission to other humans is very rapid.

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